Induction

Induction is something that has really been on my mind lately.  I hear of more and more women getting induced because they’re “sick of being pregnant.”  Oh, I’m sorry…what did you think you were signing up for when you got pregnant?  Another common reason is that they’re “overdue.”  Well, there are a few things wrong with that. 

1. Humans have the most variable gestation length of all mammals.  No one can predict when your baby will be ready to arrive.

2.  Every baby, woman and pregnancy is different.  Yes, pregnancy is an average of 40 weeks, but did you know that first time pregnancies are more around 41 weeks?  Yet so many providers are anxious to get those babies out by 41 weeks!  The ACOG (American College of Obstetrics and Gynecology) actually recommends labor induction at 42 weeks, NOT 41 weeks unless medically necessary.  It’s true that the longer the pregnancy the greater the risk for postmaturity syndrome.  The placenta can become “old” and calcify, which presents health risks for the baby, amniotic fluid can decrease, and the baby can stop growing or lose weight.  But if the mom is watched closely and everything is made sure that everyone is healthy, there’s no reason to just let nature take its course.  A normal, full-term pregnancy is considered anywhere from 37-42 weeks…which, of course, is all relative, as well.  But actually, post 42 weeks is usually safe, as the ACOG has stated that 95% of babies born between 42 and 44 weeks are born safely.    

3.  Due dates are estimates.  No one can know exactly when a baby will arrive.  We do our best based off of last menstrual period, but even that is inaccurate because not every women has the textbook 28 day cycle with ovulation on day 14.  Sometimes the due date is calculated with an early ultrasound, but it all boils down to when both mom and baby are ready.  Pregnancy length is also dependent upon ethnicity, number of previous pregnancies, your age, weight, and (but not limited to) prenatal nutrition.  I’ve actually read a few places that the current way that due dates are calculated (Naegele’s Rule) is not the most accurate because most women do not have the textbook 28 day cycle with ovulation on day 14.  Mittendorf’s Rule takes into account different cycle lengths.  You can check that all out here: http://www.transitiontoparenthood.com/ttp/parented/pregnancy/duedate.htm

4.  There are a few theories on what actually triggers labor.  For a while, it was believed that the mother’s body is the one that starts labor, but now researchers believe that it’s actually the baby who is responsible for triggering labor.  One is that the baby’s lungs secrete a chemical when they’re fully developed.  This chemical causes prostaglandins to be released into the mother’s system, which trigger cervical changes and contractions.  Another theory is that, when the baby is ready to be born, its adrenal glands send out hormones to the mother’s body, signaling labor to start.  Just think – if a woman is induced before the baby’s lungs or other important body functions aren’t quite ready, that baby could have problems for their entire life.

If you are faced with the threat of induction, ask your provider what your alternatives are.  You always have the right to ask – they can’t make you do anything you don’t want to do.  You can do NSTs (Non-Stress Tests) and amniotic fluid tests to make sure that baby is healthy.  And as long as mom and baby are healthy, there is little risk of waiting until baby is ready, as Pitocin brings on problems of its own (I’ll address that in another post).

Also, don’t let your provider scare you into thinking you have a big baby.  Cephalopelvic disproportion (CPD - when the baby’s head is too big for the mother’s pelvis, which makes a vaginal birth impossible) is very rare (about 1 in 250, and even if you are diagnosed with CPD, that doesn’t mean you’ll have it again in subsequent pregnancies), yet doctors tend to diagnose many many women with this based on an inaccurate ultrasound calculation.  The only way to truly diagnose CPD is when the mother is actually in labor.  And even if they don’t threaten with CPD, you might be scared that your baby will be really big and you’ll tear or not be able to birth a “big” baby.  First off, if you listen to your body, have good coaching from your provider, let them stretch you and allow yourself to stretch, your tearing will most likely be minimal to possibly nothing!  Second, bodies are amazing things, and even if your baby IS bigger than the average newborn, you’ll be amazed at what your body can do.

My experience: I have known my exact ovulation date with every one of my (three) babies and my pregnancies were all past my “due date,” each going longer than the last!  My third baby was born at 41w5d after a LOT of encouragement.  I was confident that the baby would come when she was ready, but anxious because the 42 week mark was quickly approaching.  When she was born, she was only 7 lbs 8 oz and neither she nor the placenta had signs of “old age.”  If I would have given in to the thinking that my baby was in danger once I hit 40 or 41 weeks, think how small she could’ve been.  She just wasn’t ready.

Moral of the story:  Just let your body do what you know it can do.  Having this deadline of when the baby is “supposed” to arrive makes a woman and everyone close to her very anxious and stressed out as that date draws nearer.  When a mom can relax, it can help her go into labor – being tense just prolongs it.  Instead of having a due date, have a due window.  So say you are due February 17.  Your due window would be 3 weeks before and 2 weeks after, being Jan 27-Mar 3.  It helps to lessen the deadline part of pregnancy.

"One Born Every Minute"

Lifetime has a new show called "One Born Every Minute."  I was very excited and interested when I saw the preview, as I am with all things childbirth.  But I watched it last Tuesday and it got me VERY wound up.  The show takes place in an L&D ward in a hospital where they have installed 40 cameras to catch "all the action." Every episode they follow a few women's journeys to bring their babies into the world.  I thought it might be different than the shows that are currently on TV.  I was wrong.  Totally and completely wrong.  I was yelling at the TV practically the entire time.  I know they manipulate things to make it more dramatic, but some things you just can't fake.  Three of the four women they followed got epidurals, and the fourth one had to fight to just be left alone when her labor was taking "too long."  

The narration was ridiculous, making it sound like it was a horrible thing to NOT want an epidural and that women were finally pain-free once the anesthesiologist was finished.  No one treated birth like a normal, natural process.  It was a constant monitoring to make sure things were going normally and "textbook-ly." 

The saddest part about this show is that it is the epitome of birth in America.  If you want to know what an average birth is like in a hospital, watch this show.  If you don't want a predetermined view of birth, don't watch it.  I will say, though, that it is a good source to prepare you for what the normal processes are (so you know what you'll need in your birthplan) if you are having a hospital birth.  But please, only watch it if you feel strong in your decision to have an unmedicated birth.  Watching birth shows, especially when they show you a twisted view of it, can really affect anyone, especially a pregnant woman...and especially one who is planning a natural birth.  This is not how birth should be, and it's not how birth is if you are in control of the decisions that are made.

It's on Tuesdays at 10:00 pm ET on Lifetime...if you're interested.

On the road again

I've taken a HUGE break from blogging.  I was busy baking a baby of my own, going 12 days past my "due date," and juggling 3 kids 3 and under!  So it's a new year and I'm ready to write all the thoughts that have been floating around in my mind that I've been wanting to share.

I finished up observing the Hypnobabies class on August 10.  It was awesome, and I HIGHLY recommend a Hypnobabies course.  I thought it would be 6 weeks of just meditation and hypnosis, and you'd have to take a general childbirth class in order to get all that information.  But this included everything a couple should know: a healthy pregnancy diet, general info on the labor process, choices in childbirth, and new baby care.  It was awesome!  Hypnobabies also offers a home study course that would be great if a class isn't offered in your area.  Hypnobabies

I also read a few books.  I may have written about them before, but I will again.  :)  I've read:

Ina May's Guide to Childbirth: I love, love, LOVE this book.  Ina May talks so colloquially - you feel like she's talking right to you throughout the book.  She has great stories and her view of birth is so natural...because birth IS natural.

The Birth Partner: Another amazing book.  Most childbirth books I've read are very medical.  They talk about having a baby without medication, only it's just a paragraph or so before they move on to pages about epidurals and narcotics.  Yeah, what a great way to tell the mother that her body was made to birth babies... "you could probably do it without pain medication, but why would you when you have all these options that will make it easier?"  The Birth Partner leans more toward the natural side of birth.  It gives you the facts about epidurals, pitocin and c-sections, as well as good, real information of the childbirth process.  And my favorite part is that it's written to dads/birth partners.  It's so important to get dads involved but it's usually the moms that do the reading and the dads just kinda sit back and nod.  Then when it's time for baby, they freak out because they don't know what's going on.  This book is a great way to inform dad (and mom).

Your Best Birth: This book was written by Abby Epstein, who helped make the film The Business of Being Born with Ricki Lake.  It's does a great job in comparing options such as OB vs Midwife and places to birth.  It's very pro-midwife and home birth (so don't be put off by that if you're not into it), but it still has lots of great information.

I'm currently reading The Nursing Mother's Companion, and I really like it so far!  I'll write a post on it when I'm done.

I've attended 2 births already this year!  Both moms were due on January 9, and one had her baby on the 13th and the other on the 15th.  It was so amazing to be a part of each birth.  The first birth was in the hospital, and she did a wonderful job.  I was very nervous, as this was my first birth with someone I didn't know very well.  But I quickly got enough confidence and things worked out very well.  The second birth was a waterbirth at home and was absolutely fantastic to witness.  I can't imagine having a baby any other way now.  It was so natural and beautiful.  She listened to her body and her midwife let her do her own thing.  I had to pull out a lot of doula tricks that I've only read about, so it was a bit of a challenge, but we got through it just fine.  Now all I need to do is convince Jonny that a homebirth is a good idea! ;)

So that's about it for now.  My goal is to get apply for my certification by the end of August.  It shouldn't be a problem...I just have to do it.  I'm going to take a little break from attending births, as much as I would love to do them all the time.  My absence was a little hard on Kate (4 months), as well as myself since I couldn't leave the mom to go pump (even though I thought I would, I just couldn't bring myself to leave them).  So in a couple months when she's older and eating solids, I think I'll take on another client for my last certifying birth.  There are plenty of pregnant women around here!

Why Do I Choose Natural Childbirth?

I have to admit...when I was pregnant with Lily, it started as something I wanted to do because my sister did it.  Then, after I would tell people I was planning a natural childbirth (NCB) and they would say "good luck" and "just wait until those first contractions come - you'll be begging for your epidural," it became something I had to prove.  Comments like that just fueled my fire - being the stubborn person that I am.  I had done some research then, but just enough to know that I didn't want an epidural, I wanted the option of laboring in the tub, I wanted to move around, and a couple of other 'minor' things.  Even though Lily's birth didn't go completely as planned, I succeeded in having a NCB.  It felt good to be able to prove to everyone else that I did what they thought I couldn't do.  But there were things about how my labor went that I knew didn't have to have gone the way they did.  I wished I could have changed them, so I started to educate myself more about alternatives to routine procedures.  I began to learn why so many people choose NCB - that it was about trusting your body, and giving you and your baby the best in labor and delivery.  

A woman's body knows what to do.  I've heard stories of women being completely knocked out during labor 60+ years ago.  I always wondered how the baby was born if the woman wasn't conscious to push it out.  Well guess what?  Her body will push even if she's not trying!  A baby can be born even if a woman is in a coma!  So why do doctors and hospitals feel the need for all these interventions?  Why are women led to believe that they need help to have their baby and that they NEED all of these things that hospitals 'require.' (Which is not true, by the way.  You can always say no and hospitals actually don't have many requirements - and most of those are for women with epidurals, pitocin, etc.) 

So what started as something to prove ended up leading me to see that a NCB is safer than having interventions.  I trust my body.  It knows what to do, and if I just let it do its thing, I don't need anything to 'push' me along. 

Now, I do realize that there are circumstances in which interventions are necessary.  I'm not saying that a NCB is the ONLY way to birth.  I'm just saying that it's the safest.

Did you know that all of the routine and "just in case" procedures that OB/GYNs are made for high risk moms?  A low risk mom actually doesn't need to have most of the things that they do during pregnancy or in hospitals during labor (like an IV, rupture of membranes, episiotomy, etc).  Low risk women really should use a midwife as their caregiver.  I love this article.  It really gives you perspective on how behind the US is in our healthcare in relation to low risk obstetrics.  One quote, if you don't want to read the whole thing:  "Today, only 7 percent of births in the United States are attended by midwives. This statistic is striking, considering that midwives attend approximately 70 percent of births in Western Europe."  And when you look at the intervention rate, among other things, of Western Europe compared to the US...it's shocking, especially when you consider how 'advanced' the US is in its technology.

Anyway, I kinda went off on a tangent there.  It's really hard for me to stay on one subject, since everything is so connected!  But I hope that this gives you a better idea why I choose to birth naturally!

DONA Workshop: Day 3

I'm really late with this post...life just gets busy!  The last day of my workshop was great, just as the other days!  We really focused on interventions and how doulas can help in epidural and cesarean births.  One thing I learned that I found really interesting is the "rest and descend" technique used when the mom has an epidural.  When the woman is fully dilated, the nurses/doctors say "ok!  Time to start pushing!"  And so much energy is wasted because the baby is still high up and the mom can't push as effectively since she has little to no feeling.  So the rest and descend technique allows the contractions to move the baby down until the head is visible in between contractions (on the perineum).  Since the mom usually doesn't feel the urge to push, she can just let the contractions do the work for her.

I had an amazing three days at the workshop with an amazing group of women.  It was so great to be with people who share the same passion as I do about birth.  I really wish I could start attending births right now...but it's just not going to work with me being so far along in my pregnancy...then having a nursing baby!  The earliest I'll start is January for my cousin's birth.  But that's not too far off, and it will give me time to read and study some more.

DONA Workshop: Day 2

I am so exhausted, so this will be a short post.  At today's class, we spent most of the day doing "hands on" stuff.  We learned massage techniques and pressure points, as well as practiced different positions for labor.  Even though I knew most of the positions, it was so great to be able to practice them and to actually learn how to do them.  

By doing all of the hands on stuff today, my confidence in my ability to be a good doula definitely went up.  I learned that it doesn't always matter if you're doing something "wrong."  Sometimes the mother in labor just wants something.  She doesn't know or care that I'm not a perfect massage therapist.  What she needs is someone to help her relax, just by touch.  Or to help her slow her breathing down.  Or someone to suggest changing positions.  There's still a lot to remember, but it feels more manageable. 

Tomorrow is the last day of class.  I've had a great time being with 10 other women who pretty much have the same feelings about labor as I do.  It's sad that tomorrow's the last day!  Well hopefully I'll be able to find my own circle of women who share the same beliefs - whether that be friends or other doulas.  It's nice to have people who you can talk openly to about these kinds of things.

DONA Workshop: Day 1

Today was day one of three of my DONA workshop.  A lot of the information was basically just a review of a lot of the things I've researched and read in the past 2 years, but I still enjoy learning and talking about it.  If I had to sum up the topics of the day into one sentence, it would be:

Birth is safe, interference is risky.

Childbirth is safe. Women have been having babies [relatively] safely for thousands of years.  Why is it that NOW it's treated as an illness and a lawsuit?  (More about that in a later post.) 

I have a passion for birth...if I didn't, I wouldn't want to be a doula.  But after today, I'm just worried that I won't have what it takes to be a good doula.  There is so much information to learn...so many things to remember during labor.  And on top of that, every situation and every mom is different.  THEN, you have to learn to say things positively and not overstep your boundaries...then there's the issues you have with the hospital staff and care providers who don't like you there because you don't "let" them do things their way (even though "their" way is not what the mom wants or may not be the best solution).  There's just so much stuff to remember...


I hope that the worry and the anxiety go away after I have some experience.  I know things will naturally get easier when I get some practice, it's just very intimidating to think about!


Well, that's it for today.  Tomorrow we're doing some hands-on stuff, which I hope will ease my fears a little bit.  Stay tuned!